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Progressions 2012

Bringing convenience and efficiency to health care

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One of patients' top concerns is expense.

JuneFelix

CitigroupManaging Director, Global Enterprise Payments

Historically, life sciences companies, payers and providers have done business mostly with each other rather than directly with the ultimate consumers — patients. This relative lack of consumer experience makes it more challenging to develop a patient-centric businesses model. Here is where financial services organizations have a lot to offer — we have a long history of serving individuals, and we have developed sophisticated expertise in understanding consumer behavior and addressing consumers' primary concerns.

One of patients' top concerns is expense. Clearly, the better they can handle their expenses, the more empowered and responsible they can be about their health. Right now, consumers need simplification, clear and relevant information and convenience in payment. At the same time, businesses are wasting a huge amount on invoicing, payment processing and debt collection: in the US, patients are paying $350 billion for health care, and payers and providers are spending $300 billion to get that money and process it.

That's tremendously inefficient. Financial services organizations are very experienced in consumer billing and payment and offer improved processes that are already bringing clarity and efficiency to health care. For example, Citi's Global Enterprise Payments service is designed to streamline billing information and explanations of benefits for the patient, and it provides useful summaries for the individual or family. By making expense and benefit information clearer and more relevant to the individual, we're enhancing patient control, decision-making, planning and responsibility.

Banks are innovating in other ways to make people's lives easier and empower them to be healthy. For example, Citi recently launched the Flu Care card to facilitate flu shots. Rather than sponsoring a flu clinic, companies can issue Flu Care cards that allow employees to go to their pharmacy of choice and get their shots without any paperwork or exchange of money — they just show their card and an ID. It's much cheaper for companies and payers, too, than flu clinics in the office or trips to the doctor. For both patient and employer, the card brings simplicity, convenience, choice and cost reduction to the whole flu shot experience. And these drive adoption.

Driving patient behavior

The financial services industry has been analyzing consumer behavior for a long time (Citi has a 300-person decision management and analytics team). We've found that you can double adoption rates merely by providing relevant information in a highly clear, convenient way and making it very easy to act on. This correlation shows just how important this kind of information is to people in their decision-making, as well as the potential importance of it at every point in a business model where you want patients to make good decisions.

Incentives make it easier for us to do things we may not be very motivated to do. And they can be used to encourage people to make healthy choices. Our card services can help health plans and employers drive healthy behavior in individuals through a combined analysis of purchasing, website behavior, responses to incentives (a points program) and personal profiles.

Citi has an online catalog of 3 million items, including 30,000 wellness items, and we can analyze activity to determine the best way to stimulate certain purchases or other health activity, such as a health risk self-assessment. We now offer a rewards platform, based on our point system, that health plans and employers can use to encourage employees to make healthy choices and take more responsibility for their wellness.

We've learned that incentive programs are powerful not only because they sway choices, but also because they keep people engaged, keep them coming back, keep them thinking. This is a high priority as patients and organizations work together on prevention and patient compliance. If your incentives can engage your patients with information that's clear, relevant and easy to act on, you'll find you have some very empowered patients.

EY refers to the global organization, and may refer to one or more, of the member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients.